<div class="easyui-layout" data-options="fit:true,border:false">
	<div class="easyui-panel edit-panel" data-options="openAnimation:'slide',closeAnimation:'slide'">	
		<div class="well well-small" style="margin-left: 5px;margin-top: 5px">
		
			<p>
				<span class="badge"><font color="blue">提示</font></span>
				<span class="label-info"><strong><font color="red">红包礼品退还记录必须提交审核并通过后,方能计入医德档案</font></strong></span>
			</p>
		</div>
		
		<div data-options="region:'center',border:false" title="" style="overflow: hidden;padding: 10px;">
			<div class="edit-btn" style="height:auto;width:auto">
				<div style="margin-bottom:5px">				
								
				</div>  		
		    </div>
			<form class="main-form" method="post">		
				<fieldset>								
					<input name="id" id="id"  type="hidden"/>
					<input name="tmpid" id="tmpid"  type="hidden"/>
					<input name="created" id="created"  type="hidden"/>
					<input name="creater" id="creater"  type="hidden"/>	
					<input name="person_code" id="person_code"  type="hidden"/>
					<input name="org_id" id="org_id"  type="hidden"/>
					<input name="status" id="status"  type="hidden"/>
					<input name="repayment" id="repayment"  type="hidden"/>									
					 <table>
						 <tr>
						    <th>医生姓名</th>
							<td><input name="person_name" id="person_name" buttonText="选择" class="easyui-textbox easyui-validatebox" type="text" style="width: 300px" data-options="required:true,editable:false"/></td>							
						 	<th>科室名称</th>
							<td><input name="org_name" id="org_name" type="text" style="width: 300px" class="easyui-textbox easyui-validatebox" data-options="readonly:true"/></td>
						 </tr>
						 <tr>						    
							
						 </tr>
						 <tr>						    
							<th>患者姓名</th>
							<td><input name="patient_name" id="patient_name" type="text"  class="easyui-textbox easyui-validatebox" style="width:300px" data-options="required:true"/></td>
						 	<th>退还金额</th>
							<td><input name="money" id="money" type="text" style="width:280px" class="easyui-textbox easyui-numberbox" data-options="required:true,min:0,precision:2,invalidMessage:'请输入数字'"/>元</td>
							
						 </tr>
						 <tr>						    
							<th>退还方式</th>
							<td><input name="repayment_id" id="repayment_id" type="text"  class="easyui-textbox easyui-validatebox" style="width:300px" data-options="required:true"/></td>
						 	<th>退还日期</th>
							<td><input name="integritydate" id="integritydate" type="text" style="width:300px" class="easyui-datebox easyui-validatebox" data-options="required:true"/></td>							
						 </tr>
						 					 
						 <tr>
							<th>描述</th>
							<td colspan="3"><input class="easyui-textbox" id="remark" name="remark" data-options="multiline:true,required:true" style="width: 680px;height: 100px;"/></td>
						</tr>
						<tr>
							<th>审核意见</th>
							<td colspan="3"><input class="easyui-textbox" id="auditMsg" name="auditMsg" data-options="multiline:true" style="width: 680px;height: 100px;"/></td>
						</tr>
					 </table>
				</fieldset>
			</form>
		</div>
	</div>

	<div class="easyui-panel upload-panel" data-options="closed:true,openAnimation:'slide',closeAnimation:'slide'">
		<div class="archive-btn">
			<a href="javascript:void(0);" class="easyui-linkbutton file_upload_btn" iconcls="icon-add" plain="true">上传</a>
			<a href="javascript:void(0);" class="easyui-linkbutton file_upload_btn" iconcls="icon-remove" plain="true">删除</a>
			<a href="javascript:void(0);" class="easyui-linkbutton file_upload_btn" iconcls="icon-undo" plain="true">返回</a>
	    </div>
		<div class="table-archive"/>
		<form class="upload-form">
			<div id="queue"></div>
			<input id="file_upload" name="file_upload" type="file" multiple="true">
			
		</form>
	</div>
</div>
	<script>

requirejs(['editPage','gift','domReady!'],function(editPage,gift,doc){
	editPage.init({doc:doc,
		rootId:'panel-ethic-gift',
		subSystemCode:'ethic',
		moduleCode:'gift',
		editWindow:'ethic-gift-win',
		initElement:gift.initEdit,
		auditEnable:true,
		saveValidate:true,
		beforeSubmit:gift.beforeSubmit,
		fileType:'image/*'
	});
});	
</script>